Booth, Jason

Booth, Jason is an individual health care provider with primary practice located at 3933 Mount Vernon Rd Se , Cedar Rapids IA 52403-3869. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Booth, Jason can be contacted via phone (319) 363-8148.

Contact Information

Primary practice address
3933 Mount Vernon Rd Se Cedar Rapids IA 52403-3869
Phone: (319) 363-8148
Fax: (319) 363-9118
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 33657 Iowa

Profile Details

NPI number 1861460495
LBN Legal business name Booth, Jason
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Oct 25th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861460495 NPPES
Iowa MEDICAID 0228692

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